A Very Busy August ...

The so-called August policy-making lull has been anything but relaxing for MHA as the association was active over the past two weeks at both the state and federal levels, commenting on the MassHealth waiver amendment, Health Safety Net funding, Medicaid DSH funding, and, most recently, waiving certain aspects of the Affordable Care Act.

In an August 21 letter on the MassHealth waiver to the Executive Office of Health and Human Services (EOHHS), MHA weighed in on Governor Baker’s proposed changes to MassHealth coverage, including the proposal that disallows MassHealth coverage for non-disabled adults who have access to affordable employer health insurance. MHA took a deep dive into the waiver, analyzing in depth nine of its specific proposal. MHA stated that the administration’s proposed MassHealth reforms can serve as the basis for addressing the sustainability of the MassHealth program. MHA also noted that improvements must be made to it to ensure than any changes to health coverage are affordable and take into consideration low-income patients who may fall through the cracks.

In an August 11 letter to new House Ways & Means Chair Jeffrey Sánchez and Senate Ways & Means Chair Karen Spilka, MHA made a strong pitch to include much needed legislative language for a $15 million transfer to the Health Safety Net (HSN) as part of the supplemental budget. With one month remaining in Health Safety Net 2017 fiscal year, a state funding transfer has still not occurred.

On August 28, MHA submitted formal comments to CMS Administrator Seema Verma, asking CMS to delay its proposed rule to implement Medicaid State Disproportionate Hospital allotment reductions beginning in FY2018. According to CMS estimates provided in the proposed rule, Massachusetts will experience a 31.45% reduction in FY2018 alone – the largest reduction in the country. The outlook for further reductions is overwhelming given the cuts increase each year and will effectively quadruple by 2024.

On August 24, MHA wrote to the Health Connector on the issue of the state’s proposed “Section 1332” waiver to the Affordable Care Act. Through that waiver, the state hopes to establish a Premium Stabilization Fund in lieu of federal Cost-Sharing Reductions (CSRs) for low-income enrollees who purchase health insurance in the Connector. MHA supports the state’s efforts but added: “If a Premium Stabilization Fund is created on the commonwealth’s books, it should be crafted in a manner that includes protective language to ensure these funds cannot be used for other purposes.”